| NPI | 1649554593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OK 31016) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL 30871) |
| 207X00000X Orthopaedic Surgery (Licence: NY P91524) | |
| 207X00000X Orthopaedic Surgery (Licence: ZZ 2004021303) | |
| Enumeration Date | 2011-10-10 |
| Last Update Date | 2015-10-14 |